James, Hoyer, Newcomer & Smiljanich, P.A.

Last updated
James Hoyer, P.A.
Headquarters Florida
Major practice areas Whistleblower
Website www.jameshoyer.com

James Hoyer, P.A. (James Hoyer) is a Tampa, Florida-based law firm that focuses on whistleblower ( qui tam ) cases as well as consumer class action lawsuits. [1] In 2015, the firm was named Whistleblower Lawyers of the Year by the Taxpayers Against Fraud Education Fund.

Contents

History

The firm was founded in 1992 by former State Attorney for Hillsborough County Bill James, former federal prosecutors, and retired FBI agents. [2] Since its founding, James Hoyer has helped return more than $3 billion to consumers and taxpayers who were victims of fraud. [3] The St. Petersburg Times once called James Hoyer one of Tampa's most successful law firms. [4]

Members of the James Hoyer firm operate the Consumer Warning Network. [5]

Notable Cases

In 1994, MetLife agreed to pay $42.75 million in refunds to 18,000 customers after James Hoyer, along with co-counsel, brought suit against the company for using misleading tactics to sell life insurance as a retirement or savings plan. [6] MetLife also agreed to pay a $20-million fine to insurance regulators across the country in relation to the lawsuit. [6] The 18,000 MetLife customers received an average of about $2,200 in refunds and interest, for a total payout by Met Life of $39,600,000. The attorney's fees paid by Met Life for the multi-year litigation, approved by the Court, was $2.75 million, according to the New York Times article. [6] Met Life also agreed to change the fraudulent practices it had been accused of. [6]

In 2000, James Hoyer helped negotiate a $206 million class action settlement with insurer American General Corp., on behalf of thousands of African American customers who were systematically overcharged due to their race for small "burial" policies. [7]

In 2005, James Hoyer helped secure $52 million in new funding for Florida's elderly in nursing homes. [8] The firm fully funded all the costs of the litigation and donated all of the legal time. [8] James Hoyer received the Chair's Honor Award from the Elder Law Section of the Florida Bar for the firm's efforts. [8]

In 2006, James Hoyer helped secure a class action settlement in which Allstate Insurance Co. agreed to change the way it uses credit reports in setting auto and homeowners insurance policies. [9]

In 2008, James Hoyer was recognized by the Florida Bar for securing a $295,000 cy pres award for The Florida Bar Foundation. [10] The Florida Bar Foundation is the only statewide organization in Florida that provides funding for Legal Aid and promotes improvements in addressing the civil legal needs of the poor. [11]

In 2010, The Wall Street Journal reported on the firm's use of social media to connect with students of Westwood College, a for-profit school which the firm was pursuing litigation. [12] The Journal also reported that Westwood College had filed a suit against James Hoyer, alleging defamation through "new media Internet weapons". [12]

In 2012, James Hoyer represented one of four whistleblowers in a qui tam case against WellCare Health Plans, Inc that resulted in a $137.5 million settlement. [13] The lawsuits alleged a number of schemes to submit false claims to Medicare and various Medicaid programs. [13]

In 2013, a Las Vegas Review-Journal article [14] profiled the case of a military whistleblower represented by James Hoyer. The case of Lt. Col. Timothy Ferner vs. giant defense contractor SAIC resulted in a nearly $6 million settlement. [15]

In 2014, James Hoyer represented a whistleblower in a qui tam case against Endo Pharmaceuticals that resulted in a $193 million settlement [16] with the Department of Justice. The lawsuit alleged that the makers of the Lidoderm Patch were marketing the pain reliever for unapproved uses. [16] James Hoyer's client was found to be the sole relator entitled to share in the award by District Judge Robert Kelly in June 2014. [17] In July 2015, Judge Kelly ordered the government to pay James Hoyer's client 1% less than the 25% maximum for her "extraordinary" efforts during the decade long litigation. [18]

In 2015, James Hoyer represented a whistleblower in a qui tam/False Claims Act case against Education Management Corporation (EDMC), which was part of a global settlement for $99.5 million with the Department of Justice. EDMC is the second largest for-profit education company in the United States and was accused of unlawfully recruiting students using deceptive and misleading practices.

In 2016, the firm represented a whistleblower who filed a lawsuit under the False Claims Act has led to an $18 million settlement with two of Indiana’s largest health care providers, Indiana University (IU) Health and HealthNet. [19] The settlement covered three areas: inappropriate billing when Certified Nurse Midwives, instead of doctors, cared for high risk pregnant women, in violation of Indiana Medicaid rules; kickback claims, regarding various financial schemes between IU Health and HealthNet, which improperly induced referrals; and false claims for “wrap around” payments, which are payments made to FQHCs to supplement their care to the poor.

In 2018, James Hoyer represented a whistleblower who was instrumental in achieving a $65 million settlement between the government and the 5th largest for-profit hospital system in the country, Prime Healthcare. [20] The settlement resolved allegations that 14 Prime hospitals in California knowingly submitted false claims to Medicare by admitting patients who required only less costly, outpatient care and by billing for more expensive patient diagnoses than the patients had (a practice known as “up-coding”).

See also

Related Research Articles

<span class="mw-page-title-main">False Claims Act of 1863</span> United States federal anti-fraud law

The False Claims Act of 1863 (FCA) is an American federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal government's primary litigation tool in combating fraud against the government. The law includes a qui tam provision that allows people who are not affiliated with the government, called "relators" under the law, to file actions on behalf of the government. This is informally called "whistleblowing", especially when the relator is employed by the organization accused in the suit. Persons filing actions under the Act stand to receive a portion of any recovered damages.

In common law, a writ of qui tam is a writ through which private individuals who assist a prosecution can receive for themselves all or part of the damages or financial penalties recovered by the government as a result of the prosecution. Its name is an abbreviation of the Latin phrase qui tam pro domino rege quam pro se ipso in hac parte sequitur, meaning "[he] who sues in this matter for the king as well as for himself."

<span class="mw-page-title-main">Omnicare</span> American health care company

Omnicare is an American company working in the health-care industry. It was established in April 1981 as a spinoff of healthcare businesses from Chemed and W. R. Grace and Company. It is currently a pharmacy specializing in nursing homes. In 2015, Omnicare was acquired by CVS Health.

Community Health Systems (CHS) is a Fortune 500 company based in Franklin, Tennessee. It was the largest provider of general hospital healthcare services in the United States in terms of number of acute care facilities. In 2014, CHS had around 200 hospitals, but the number had declined to around 85 in 2021.

WellCare Health Plans, Inc. is an American health insurance company that provides managed care services primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug plans for members across the United States.

James Barry "Jim" Gottstein is a mostly retired Alaska based lawyer who practiced business law and public land law, and is well known as an attorney advocate for people diagnosed with serious mental illness. Gottstein has sought to check the growth in the administration of psychotropics, particularly to children.

Centene Corporation is a publicly traded managed care company based in St. Louis, Missouri, which is an intermediary for government-sponsored and privately insured healthcare programs. Centene ranked No. 25 on the 2023 Fortune 500.

In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately.

Education Management Corporation (EDMC) was a Pittsburgh, Pennsylvania-based operator of for-profit post-secondary educational institutions in the United States and Canada. The company was founded in 1962. At its peak in 2011, Education Management Corporation operated 110 schools through its higher education divisions: Argosy University, The Art Institutes, Brown Mackie College, and South University, and enrolled 158,300 students.

Adam B. Resnick is an American health care entrepreneur, public speaker, author, and professional whistleblower.

Shasta Regional Medical Center, formerly known as Redding Medical Center and Memorial Hospital, is a general acute care hospital that is located in Redding, California. It opened in 1945 and currently has 226 beds with a basic emergency department.

Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare or equivalent State programs. The manner in which this is done varies, and persons engaging in fraud are always seeking new ways to circumvent the law. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).

<span class="mw-page-title-main">Stefan P. Kruszewski</span> American clinical and forensic psychiatrist

Stefan Philip Kruszewski is an American clinical and forensic psychiatrist, active as a whistleblower in medically related cases. He is principal in the company which bears his name, Stefan P. Kruszewski, M.D. & Associates, P.C. in Harrisburg, Pennsylvania.

Pharmaceutical fraud is when pharmaceutical companies engage in illegal, fraudulent activities to the detriment of patients and/or insurers. Examples include counterfeit drugs that do not contain the active ingredient, false claims in packaging and marketing, suppression of negative information regarding the efficacy or safety of the drug, and violating pricing regulations.

<i>United States v. GlaxoSmithKline</i>

United States v. GlaxoSmithKline was a case before the United States District Court for the Eastern District of Pennsylvania. Robert J. Merena was one of the first who filed claims against SmithKline Beecham Clinical Laboratories on November 12, 1993. The complaints alleged that GlaxoSmithKline, which operated a system of clinical laboratories, adopted myriad complicated procedures for the purpose of defrauding state and federal healthcare programs, in particular Medicare and Medicaid. The U.S. Justice Department publicly praised Robert Merena for his "cooperation and support" in helping the government collect the largest settlement ever involving a whistle-blower lawsuit. The SmithKline settlement is considered to be one of the largest whistleblower assisted recoveries in the history of the United States.

<i>Franklin v. Parke-Davis</i>

Franklin v. Parke-Davis is a lawsuit filed in 1996 against Parke-Davis, a division of Warner-Lambert Company, and eventually against Pfizer under the qui tam provisions of the False Claims Act. The suit was commenced by David Franklin, a microbiologist hired in the spring of 1996 in a sales capacity at Parke-Davis, a pharmaceutical subsidiary of Warner-Lambert. In denying the defendants' motion for summary judgment, the court for the first time recognized off-label promotion of drugs could cause Medicaid to pay for prescriptions that were not reimbursable, triggering False Claims Act liability. The case was also significant in exposing the degree to which publication bias impacts the randomized controlled studies conducted by pharmaceutical companies to test the efficacy of their products. Ultimately, the parties reached a settlement agreement of $430 million to resolve all civil claims and criminal charges stemming from the qui tam complaint. At the time of the settlement in May 2004, it represented one of the largest False Claims Act recoveries against a pharmaceutical company in U.S. history, and was the first off-label promotion settlement under the False Claims Act.

<span class="mw-page-title-main">Reuben Guttman</span> American attorney

Reuben A. Guttman, born 1959 in New York City, is an American attorney and a founding Partner of Guttman, Buschner & Brooks PLLC ("GBB"), a DC-based plaintiffs' firm His practice involves complex litigation and class actions. He has served as counsel in some of the largest recoveries under the False Claims Act. The International Business Times has called Guttman "one of the world's most prominent whistleblower attorneys," and he has been recognized as a Washingtonian Top Lawyer by Washingtonian Magazine.

IPC Healthcare, Inc., previously known as IPC The Hospitalist Company, was a publicly traded corporation which operates a national physician group practice focused on the delivery of hospital medicine and related facility-based services. IPC providers manage the care of patients in coordination with primary care physicians and specialists in over 1,900 facilities in 28 states across the U.S. The company name is derived from an earlier company called In-Patient Consultants Management, Inc. and the NASDAQ ticker name was changed to IPCM in 2008. The company changed its name to IPC Healthcare in January 2015. The company was acquired by TeamHealth in 2015 for $1.6 billion.

References

  1. ↑ James Hoyer homepage
  2. ↑ Firm Biography from James Hoyer homepage
  3. ↑ Practice Areas from James Hoyer homepage
  4. ↑ Kyle Parks, "Issues taking back seat to personality in election" St. Petersburg Times (October 23, 2000)
  5. ↑ "CWN Staff" . Retrieved 11 June 2014.
  6. 1 2 3 4 Michael Quint, "Taking on Insurance Giants". NY Times (July 19, 1995)
  7. ↑ Ted Jackovics, "Florida Ratifies Restitution Plan for Burial Insurance Policyholders" Tampa Tribune (July 11, 2000)
  8. 1 2 3 "Tampa lawyers come to aid of Florida's seniors: pro bono efforts secure elders their rights under federal Medicaid law." Florida Bar News (August 1, 2005)
  9. ↑ Becky Yerak, "Allstate settles suit on credit score use"
  10. ↑ Nancy Kinnally "Foundation benefits from cy pres award" The Florida Bar News (September 1, 2008)
  11. ↑ "About Us" section from Florida Bar Foundation's homepage
  12. 1 2 "WellCare Health Plans, Inc. Agrees to Pay $137.5 Million to Resolve False Claims Act Allegations". www.justice.gov. Archived from the original on 14 July 2014. Retrieved 11 June 2014.
  13. ↑ "Coalition and Irregular Warfare Center shows little for $42 million effort". Las Vegas Review-Journal. Retrieved 2016-01-12.
  14. ↑ "Office of Public Affairs - Science Applications International Corporation Agrees to Pay $5.75 Million to Settle False Claims Act Allegations - United States Department of Justice". www.justice.gov. 2013-07-03. Retrieved 2023-11-06.
  15. 1 2 Hughes, Claire (21 February 2014). "Upstate NY whistleblower's info leads to Lidoderm settlement" . Retrieved 11 June 2014.
  16. ↑ Lewis, Al. "Whistleblower to get millions for speaking up". MarketWatch. Retrieved 2018-08-09.
  17. ↑ Pierson, Brendan. "'Indispensable' whistleblower to get $33.5 mln of Lidoderm settlement". U.S. Retrieved 2018-08-09.
  18. ↑ "Indiana University Health and HealthNet to Pay $18 Million to Resolve Allegations of False Claims". 2017-04-27. Retrieved 2018-08-09.
  19. ↑ "Prime Healthcare Services and CEO to Pay $65 Million to Settle False Claims Act Allegations". 2018-08-03. Retrieved 2018-08-09.
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